Hysteroscopy Anesthesia for Relief of Pain

"1\. Intervention Group (Local Anesthesia) Name: Mepivacaine 3% uterosacral ligament block Type: Pharmacological (local anesthetic).~Dose/Administration:~Drug: Mepivacaine hydrochloride 3% (4 vials of 1.7 mL each, total 6.8 mL). Route: Bilateral injection into uterosacral ligaments (2 injections per ligament, 3.4 mL per side).~Technique:~Patient in lithotomy position. Uterosacral ligaments identified posteriorly to the cervix. Injection with a 27G Carpule needle (25 mm length) at 2-3 mm depth. Slow infusion (to minimize dispersion). Timing: Administered ≥1 minute before hysteroscopy."

"Procedure:~Vaginal and cervical irrigation with 0.9% saline solution (4 irrigations, mimicking anesthesia administration).~Mimicry:~Same equipment (syringe, speculum) as intervention group. Identical patient positioning and timing"